Laparoendoscopic single-site retroperitoneoscopic adrenalectomy compared with conventional laparoscopy and open surgery

Chen, Szu Han; Huang, Ching‐Wen; Sheng, Wen; Yeh, Hsin Chih; Lee, Hsiang Ying; Wu, Wen‐Jeng; Li, Ching Chia

doi:10.1016/j.urols.2016.05.001

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…A commercially available multichannel port device was used for LESS-A in the majority of the studies [ [13] , [14] , [15] , [19] , [20] , [21] , [24] , [25] , [26] , 28 , 30 , 31 , 33 , 41 ]. Three studies used a single glove or a commercially available multichannel port device [ 22 , 32 , 42 ]. In two studies, a home-made single-port device made using single-layered sterile surgical glove was used [ 29 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…The subgroup analysis revealed that patients treated with LESS-A with a retroperitoneal approach had significantly shorter hospital stay than those treated with m-LA patients. Nine studies reported the time taken for resumption of oral intake [ 13 , 15 , 20 , 21 , 25 , 29 , 30 , 32 , 42 ]. Pooled synthesis reported significantly shorter time for resumption of oral intake in patients treated with LESS-A than in those treated with m-LA (MD −0.33, 95% CI −0.60 to −0.06, p = 0.0153), with high heterogeneity ( I 2 = 95%) ( Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Operative time was reported in 19 studies [ [13] , [14] , [15] , [16] , [19] , [20] , [21] , [22] , [24] , [25] , [26] , [28] , [29] , [30] , [31] , [32] , [33] , 42 ]. The operative time was significantly longer in LESS-A than in m-LA (MD 13.43, 95% CI 4.08–22.77, p = 0.0049, I 2 = 91%) ( Fig.…”

Section: Resultsmentioning

confidence: 99%

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Laparoendoscopic single-site adrenalectomy versus multi-port laparoendoscopic adrenalectomy: A systemic review and meta-analysis

Kang

et al. 2021

Annals of Medicine &Amp; Surgery

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Background To investigate the outcomes of laparoendoscopic single-site adrenalectomy (LESS-A) compared to multi-port laparoendoscopic adrenalectomy (m-LA). Methods Studies comparing LESS-A with m-LA were identified from PubMed, Embase, and Cochrane Library before June 2020. Post-operative pain, resumption outcomes, and perioperative outcomes were analyzed. We conducted meta-analyses using the Mantel-Haenszel method with random-effects model. Subset analyses were conducted according to peritoneal and retroperitoneal approaches. A small study effect was illustrated using funnel plots and Egger's test. Results One randomized controlled trial (RCT) and nineteen retrospective cohort studies involving 1554 patients were included for analyzed. Pooled analysis showed that LESS-A had significantly lower postoperative pain scores (MD −0.77, 95%CI −1.45 to −0.10) and less pain medication used (RR 0.74, 95%CI 0.60 to 0.91) compared to m-LA. Besides, LESS-A had significantly shorter hospital stays (MD −0.75, 95%CI −1.18 to −0.33), shorter duration of oral intake resumption (MD −0.33, 95%CI −0.60 to −0.06), and better cosmetic satisfaction (SMD 1.15, 95%CI 0.21 to −2.09). As for perioperative outcomes, LESS-A led to significant longer operative time (MD 13.43, 95%CI 4.08 to 22.77). No significant differences were observed in terms of the remaining perioperative outcomes. Conclusions LESS-A is associated with less post-operative pain and quicker recovery duration. However, the longer operative time of LESS-A compared with m-LA is a drawback.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Laparoendoscopic single-site adrenalectomy versus multi-port laparoendoscopic adrenalectomy: A systemic review and meta-analysis

Kang

et al. 2021

Annals of Medicine &Amp; Surgery

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A novel method of tunneling retroperitoneoscopic adrenalectomy: a prospective study

Zhang,

Pei,

Zhi

et al. 2024

BMC Urol

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Background To introduce the surgical technique and our team’s extensive experience with tunnel method in laparoscopic adrenalectomy. Methods From July 2019 to June 2022, we independently designed and conducted 83 cases of " Tunnel Method Laparoscopic Adrenalectomy,” a prospective study. There were 45 male and 38 female patients, ages ranged from 25 to 73 years(mean: 44.6 years).The cases included 59 adrenal cortical adenomas, 9 pheochromocytomas, 6 cysts, 4 myelolipomas, 1 ganglioneuroma, and 4 cases of adrenal cortical hyperplasia. In terms of anatomical location, there were 39 cases on the left side, 42 on the right side, and 2 bilateral cases. Tumor diameters ranged from 0.6 to 5.9 cm(mean: 2.9 cm). Utilizing ultrasound monitoring, percutaneous puncture was made either directly to the target organ or its vicinity, and the puncture path was manually marked. Then, under the direct view of a single-port single-channel laparoscope, the path to the target organ in the retroperitoneum or its vicinity was further delineated and separated. This approach allowed for the insertion of the laparoscope and surgical instruments through the affected adrenal gland, thereby separating the surface of the target organ to create sufficient operational space for the adrenalectomy. Results All 83 surgeries were successfully completed. A breakdown of the surgical approach reveals that 51 surgeries were done using one puncture hole, 25 with two puncture holes, and 7 with three puncture holes. The operation time ranged from 31 to 105 min (mean: 47 min), with a blood loss of 10 to 220mL (mean: 40 mL). Notably, there were no conversions to open surgery and no intraoperative complications. Postoperative follow-up ranged from 6 to 28 months, during which after re-examination using ultrasound, CT, and other imaging methods, there were no recurrences or other complications detected. Conclusions The completion of the tunnel method laparoscopic adrenalectomy represents a breakthrough, transitioning from the traditional step-by-step separation of retroperitoneal tissues to reach the target organ in conventional retroperitoneoscopic surgery. This method directly accesses the target organ, substantially reducing the damage and complications associated with tissue separation in retroperitoneoscopic surgery, As a result, it provides a new option for minimally invasive surgery of retroperitoneal organs and introduces innovative concepts to retroperitoneoscopic surgery.

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Laparoendoscopic single-site retroperitoneoscopic adrenalectomy compared with conventional laparoscopy and open surgery

Cited by 2 publications

References 21 publications

Laparoendoscopic single-site adrenalectomy versus multi-port laparoendoscopic adrenalectomy: A systemic review and meta-analysis

Laparoendoscopic single-site adrenalectomy versus multi-port laparoendoscopic adrenalectomy: A systemic review and meta-analysis

A novel method of tunneling retroperitoneoscopic adrenalectomy: a prospective study

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